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NEUROLOGY 2008;70:e85
© 2008 American Academy of Neurology
Resident and Fellow Section

Teaching Video NeuroImage: Waddling-steppage gait secondary to spinal arachnoid cyst

An exceptional surgical outcome

Formula

Pericles Maranhao-Filho, MD, PhD, Ricardo Magalhaes Maron, MD and Ana Lucia Zuma de Rosso, MD, PhD

From the Department of Neurology and Neurosurgery, Federal University of Rio de Janeiro, Brazil.

Address correspondence and reprint requests to Dr. Pericles Maranhao-Filho, Department of Neurology, Hospital Universitario Clementino Fraga Filho, Av. Brigadeiro Trompowiski s/n. Universidade Federal do Rio de Janeiro, RJ, Brazil 21941-590 pmaranhaofilho{at}gmail.com

Forty-five days after a substantial physical effort, a 14-year-old boy developed low back pain and severe waddling-steppage gait (video 1). Deep tendon reflexes were abolished in the lower limbs and plantar responses inapparent. A spinal MRI depicted a cyst extending from T5 to S2 (figure). A complete thoracic cyst resection (video 2) and a lumbar cyst peritoneal shunt were performed. The pathologic specimen examination was conclusive for arachnoid cyst. After 4 months, the gait was normal (video 3). Speculatively, the physical effort accentuated a ball valve phenomenon1 in a preexisting asymptomatic idiopathic arachnoid cyst.


Figure 116
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  		Figure Sagital T1-weighted gadolinium MRI of the thoracic (A) and lumbosacral (B) spinal cord showing a large, multi-lobulated posterior subarachnoid cyst extending from T5 to S2 and displacing the spine anteriorly

 

Supplemental data at www.neurology.org

Disclosure: The authors report no disclosures.


   REFERENCE
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 REFERENCE
 

  1. Sharma A, Sayal P, Badhe P, Pandey A, Diyora B, Ingale H. Spinal intramedullary arachnoid cyst. Ind J Pediatr 2004;71:e65–e67.[Medline]




This Article
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Right arrow Articles by de Rosso, A. L. Z.

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